Research Highlights
Best Paper in the Shoulder and Elbow classification, AAOS Annual Meeting, 2024
- Watchful Waiting Achieves Higher Value Than Physical Therapy for the Treatment of Idiopathic Frozen Shoulder: A Prospective Randomized Controlled Trial.
Special Recognition: AAOS Highlights Symposium, AAOS Annual Meeting, 2024
- Evaluating Disparities in Access to Surgical Management for Symptomatic Rotator Cuff Tears: A National Database Study.
Areas of Study, 2024-5
Recent Significant Publications
- Randomized controlled trial on watchful waiting vs. physical therapy for adhesive capsulitis
- Orthobiologics
- Prospective study on impact of social determinants of health on functional outcomes (actively enrolling)
- after rotator cuff repair, labral repair, shoulder stabilization surgery
Shoulder Joint Recent Significant Publications
Operative management of rotator cuff tears: identifying disparities in access on a national level
Conclusion: Relative to WW, patients randomized to PT reported similar PROMs but incurred significantly higher direct costs (10.0x) and imposed a greater economic burden on the healthcare system (3.4-6.0x). Accordingly, WW resulted in significantly higher (5.9x) patient value than PT. Although additional high-level, multicenter studies are needed to corroborate these findings, the present study may support physicians and patients in pursuing the most appropriate treatment plan for each patient based on their individualized needs and preferences.
Martin SD, Dean MC, Eberlin CT, Kucharik MP, Abraham PF, Nazal MR, Conaway WK, Cherian NC. AAOS 2024 Best Paper in the Shoulder and Elbow Classification: Watchful Waiting Provides Higher Value with Similar Functional Outcomes to Physical Therapy for Frozen Shoulder: A Prospective Randomized Controlled Trial. J Shoulder Elbow Surg. https://doi.org/10.1016/j.jse.2024.09.017 2024 Nov 11. Online Ahead of Print
Operative management of rotator cuff tears: identifying disparities in access on a national level
Conclusion: There are significant nationwide disparities in the likelihood of receiving operative management for rotator cuff tear patients of differing race/ethnicity, payer status, and socioeconomic status. Further investigation is needed to fully understand and address causes of these discrepancies to optimize care pathways.
Laporte ZL, Cherian NC, Eberlin CT, Dean MC, Torabian KA, Dowley KS, Martin SD. Operative Management of Rotator Cuff Tears: Identifying Disparities in Access on a National Level. J Shoulder Elbow Surg. 2023 May 26;S1058-2746(23)00384-1. https://doi.org/10.1016/j.jse.2023.04.007 Online Ahead of Print. PMID: 37245619
Accelerated Versus Standard Physical Therapy in Patients with Transtendinous Rotator Cuff Repair: A Propensity-Matched Cohort Study, J Shoulder Elbow Surg
Conclusion: Accelerated PT following transtendinous RCR is associated with significant improvement in AROM at 6 weeks and 3 months postoperatively. Further, the early motion may help obviate the development of severe postoperative stiffness without any evidence of higher rotator cuff retear rates.
McBroom TJ, Abraham PF, Varady NH, Kucharik MP, Eberlin CT, Best MJ, Martin SD. Accelerated Versus Standard Physical Therapy in Patients with Transtendinous Rotator Cuff Repair: A Propensity-Matched Cohort Study. J Shoulder Elbow Surg. 2021 Dec 2;S1058-2746(21)00818-1. doi:10.1016/j.jse.2021.10.039. Online Ahead of Print.
Worsening Racial Disparities in Patients Undergoing Anatomic and Reverse Total Shoulder Arthroplasty in the United States, J Shoulder Elbow Surg
Conclusion: Racial disparities in patients undergoing TSA and RTSA are worsening over time. Black patients undergo TSA and RTSA at lower rates than white patients regardless of insurance status and have increased odds of complications and mortality. Improved initiatives are needed to reduce these racial disparities and further research is warranted to understand their root causes.
Best MJ, Aziz KT, McFarland EG, Martin SD, Rue JH, Srikumaran U. Worsening Racial Disparities in Patients Undergoing Anatomic and Reverse Total Shoulder Arthroplasty in the United States. J Shoulder Elbow Surg. 2020 Nov 19;S1058-2746(20)30895-8. doi.org/10.1016/j.jse.2020.10.023 Epub 2020 Nov 18.
The new dynamic isotonic manipulation examination (DIME) is a highly sensitive secondary screening tool for supraspinatus full-thickness tears, J Shoulder Elbow Surg
Abraham PF, Nazal MR, Varady N, Gillinov SM, Quinlan NJ, Alpaugh K, Martin SD. The new dynamic isotonic manipulation examination (DIME) is a highly sensitive secondary screening tool for supraspinatus full-thickness tears. [published online ahead of print, 2020 Jul 7]. J Shoulder Elbow Surg. 2020 Nov 1; 29(11): 2213-2220. doi:10.1016/j.jse.2020.06.029 PMID: 32650076
Conclusion: DIME is highly sensitive for supraspinatus FTTs in patients with negative traditional rotator cuff PE tests for whom there is still high clinical suspicion of FTTs. Thus, this test is an excellent secondary screening tool for supraspinatus FTTs in patients for whom clinicians suspect rotator cuff pathology despite negative traditional static PE tests. Given its high sensitivity, a negative DIME test rules out supraspinatus FTT well in these patients, and can therefore better inform clinicians which patients should undergo MRI. In addition, the angle at which patients first report pain on unopposed active shoulder abduction is highly specific for supraspinatus pathology.
A value-based care analysis of magnetic resonance imaging in patients with suspected rotator cuff tendinopathy and the implicated role of conservative management, J Shoulder Elbow Surg
Cortes A., Quinlan, NJ, Nazal, MR, Upadhyaya, S, Alpaugh, K, Martin, SD. A value-based care analysis of magnetic resonance imaging in patients with suspected rotator cuff tendinopathy and the implicated role of conservative management. J Shoulder Elbow Surg. 2019 Nov;28(11):2153-2160. doi: 10.1016/j.jse.2019.04.003. Epub 2019 Jul 4.
Conclusions: The use of MRI before a trial of conservative management in patients with atraumatic shoulder pain, minimal to no strength deficits on physical examination, and suspected cuff tendinopathy other than full-thickness tears provides negative value in the management of these patients, at both the individual and population level.